This section of the protocol specifies the extent of the examination and testing to be done to stay within the scope of the protocol. This should include everything necessary to establish that the diagnostic criteria have been met and everything that might require consultation or referral:

Examination/Laboratory

1. Examine throat, ears, neck, and chest in all patients.

2. Obtain a pharyngeal swab for strep testing on one family member at a time until two family members have positive tests.

The extent of examination required does not have to be this specific. The physician and the NPP may have decided on the type of examination that is appropriate in a particular type of case. Nevertheless, the NPP must take a history and do a physical examination extensive enough to gather the information required to meet the diagnostic criteria or the criteria for referral. In this example, the history must include household and day care information, and the physical must include examination of the throat and cervical lymph nodes and listening for a heart murmur.